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Distorted Body Image Could Be Linked To Abnormal Brain Function

Body Dysmorphic Disorder (BDD), or dysmorphophobia, is a hidden disease that affects nearly three million Americans. It is hidden because patients with the disease often go to great lengths to hide from the world, often altering their appearance through plastic surgeries, wrongly perceiving themselves to be ugly or having a hideous physical flaw.

Sanjaya Saxena, Ph.D., associate professor of psychiatry at the University of California, San Diego (UCSD) School of Medicine, is leading a study to identify abnormalities in brain structure and activity that are associated with BDD, and determine how these abnormalities change with treatment. The only current study of its kind in the world, this National Institute of Mental Health-sponsored project is utilizing positron emission tomography (PET) and magnetic resonance imaging (MRI) to find out more about how the brain functions in individuals with BDD.

"Patients with body dysmorphic disorder are preoccupied with some perceived flaw," said Saxena. "Some exhibit severe avoidance, for example, they will only go out of their homes when it's dark, or camouflage themselves in public."

Saxena adds that the disorder is very different from vanity or narcissism. "Patients with BDD truly fear or even believe that they are ugly, and the condition is associated with shame and a high rate of depression and suicide," he said. The disorder is found about equally often in men as in women. Some males suffer from a particular version known as muscle dysmorphia, characterized by extreme body workouts and use of steroids in men who wrongly view themselves as being weak and out of shape.

"Some patients make repeated visits to plastic surgeons and dermatologists for procedures but are never satisfied," said Saxena, adding that about half of all BDD patients are delusional, while the others objectively know that they are okay, yet are unable to stop the compulsion to cover up or "fix" their flaws.

Psychiatric treatment for such patients is difficult, Saxena adds, but with therapy and/or medication such as serotonin uptake inhibitors (SRIs), even those who are delusional can recover.

The UCSD study includes PET and MRI scans to measure brain function and structure, along with neuropsychological testing of memory, learning, attention, decision-making and visual-spatial skills. Subjects accepted in the study will also receive 12 weeks of investigational study drug at no cost.

The study will also study patients with Obsessive-Compulsive Disorder (OCD) and Compulsive Hoarding. Saxena believes that BDD may be genetically linked to other obsessive-compulsive disorders, which he has shown in past studies to be linked to physiological changes in specific areas of the brain. In addition to the PET and MRI studies, Saxena also hopes to find out if BDD, OCD and compulsive hoarding respond similarly to treatment with venlafaxine (Effexor) a drug commonly used to treat depression and anxiety disorders.

University of California
200 West Arbor Dr.
San Diego, CA 92103
United Stateshttp://www.ucsd.edu